Gout: Causes, Symptoms, Diagnosis & Treatment | CanadaQBank

In this video, we explore Gout, a common inflammatory arthritis caused by uric acid crystal buildup in the joints. Learn about its causes, symptoms, diagnosis, and treatment options. Plus, we’ll walk you through clinical vignettes to help you apply this knowledge in real-world scenarios.

What You’ll Learn in This Video:

What is Gout, and why does it occur?
Common causes: Diet, genetics, kidney disease, and metabolic disorders
Key symptoms: Sudden joint pain, swelling, redness, and tenderness (especially in the big toe)
How to diagnose Gout: Clinical presentation, joint aspiration, and imaging studies
Treatment options: NSAIDs, colchicine, allopurinol, febuxostat, and lifestyle modifications
Clinical vignettes to test your knowledge and application skills
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Gout patient can move as such freely by body and normal patient but they can do normal physical activities 🥶🥶🥶🥶🥶🥶🥵🥵🥵

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The cause of gout is the crystal precipitation in a joint from excess uric acid in the blood (aka, hyperuricemia) in an individual who is genetically so predisposed. So the cause of hyperuricemia is the underlying cause of gout. Diet is but a small contributor to hyperuricemia. The principal cause of most hyperuricemia is the frequent prolonged episodes of lack of oxygen from the episodes of lack of breathing during sleep, known as obstructive sleep apnea (OSA).

OSA's episodes of reduced oxygen concurrently cause every cell in the body to abruptly produce excess uric acid, as well as reduce the solubility of uric acid in the blood by making the blood solvent itself more acidic, plus slow its removal by reducing kidney function. This physiology leads to hyperuricemia, possibly only during sleep, but certainly peaking at that time, and its precipitation as the urate crystals which cause a gout flare. If OSA continues for too long, it will lead to many life-threatening diseases (eg. cardiovascular diseases, stroke, hypertension, chronic kidney disease, diabetes, cancer -- all known to be comorbidities of gout) and premature death, which has also been found to occur in gout patients, whether or not their flares are well controlled by diet and medications like allopurinol. Resolving OSA early enough will greatly reduce the risk for developing these diseases, and will prevent further overnight, or even all, gout flares.

When gout flares begin to occur, they are an unignorable early warning alarm of OSA. That should prompt the gout sufferer to see a sleep physician for diagnosis and treatment as warranted. Don't bother with rheumatologists. They're clueless, and they certainly don't want to lose their cash cow gout patients to some other doctor with a different specialization. They just want to keep providing medication to prevent the pain of recurring gout flares, without any concern that they may be complicit in the premature death of their gout patients.